Migraine Disorders
Conditions
Brief summary
This is an observational study to describe the long term use of Onabotulinumtoxin A (BOTOX®) as prescribed by the physician for headache prophylaxis in adults with chronic migraine. All treatment decisions lie with the physician.
Interventions
Botulinum toxin Type A (BOTOX®) administered according to physician prescription.
Sponsors
Study design
Eligibility
Inclusion criteria
\- Prescribed BOTOX® for the prophylaxis of headaches.
Exclusion criteria
* Received treatment with any botulinum toxin Type A serotype in the last 26 weeks * Current participation in Allergan's Botox Chronic Migraine Post-Authorisation Safety Study (protocol 191622-110).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Admitted to the Hospital for Headache | Baseline (previous 3 months prior to first dose of BOTOX®) and Last Follow-up Visit (FU last) [median 21.20 months] | The Baseline value included participants who had been admitted to the hospital for headache in the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included participants who been admitted to the hospital for headache since the previous visit. |
| Mean Number of Days of Headache-related Hospital Admissions | Baseline (previous 3 months prior to first dose of BOTOX@) to FU last [median 21.20 months] | The number of admission days is presented as the mean, normalized to a period of 90 days. The Baseline value included admissions during the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included admissions since the second-to-last visit. |
| Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Baseline (previous 3 months prior to first dose of BOTOX®) to FU last [median 21.20 months] | The Baseline value included participants who had visited an HCP in the last 3 months prior to the baseline visit (first administration of Botox); the value for FU last included participants who visited an HCP since the second-to-last visit. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in the Number of Headache Days | Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months] | At each visit, participants were asked to provide the number of headache days he/she experienced in the last month. A headache day was defined as 4 or more hours of continuous headache. A negative change from Baseline (less headache days) indicates improvement. |
| Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Baseline to Last Administration of BOTOX® (ADM last) [median 20.30 months] | The MSQ is a 14-item questionnaire to measure health-related quality-of-life attributed to migraine in the past 4 weeks. Each item is scored on a 6-point scale where: 1=none of the time to 6=all of the time. There are 3 dimensions: Role-function Restrictive (questions 1 to 7; score range 7 to 42), Role-function Preventive (questions 8 to 11; score range 4 to 24) and Emotional-function (questions 12 to 14; score range 3 to 18). The individual dimension scores were converted to a score of 0 to 100; the total score ranged from 0 to 300 with higher numbers representing a better quality of life. A positive change from baseline in the dimension scores and the total score indicates that quality of life has improved. |
| Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction Scale | ADM last [median 20.30 months] | At each visit, participants and physicians were asked to indicate the level of satisfaction that he/she had with the treatment. Physicians indicated the level of satisfaction with the patient's treatment. The 4- point scale consisted of the following responses: insufficient, moderate, good and very good. The combined percentage of good and very good responses by participants and physicians are reported. |
| Change From Baseline in the EQ-5D Questionnaire Total Score | Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months] | The EQ-5D consists of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) assessed by the participant using a 3-point scale: 1=no problems, 2=some problems and 3=extreme problems. The combination of levels from the 5 dimensions results in a health state code. The total score is calculated by converting the health state code into a score: start with score 1.000=\[11111\] (perfect health state), subtract 0.081 (constant) for any other state, subtract nothing for level 1 on any dimension, subtract appropriate level 2 or level 3 value for each dimension from a table of constants \[Level 2: Mobility 0.069, Self-care 0.104, Usual activity 0.036, Pain/discomfort 0.123, Anxiety/depression 0.071\] \[Level 3: Mobility 0.314, Self-care 0.214, Usual activity 0.094, Pain/discomfort 0.386, Anxiety/depression 0.236\], subtract 0.269 if any dimension has a level 3 problem. Higher numbers indicate better health. A positive change from Baseline indicates improvement. |
| Change From Baseline in the Health State Score of the EQ-5D Questionnaire | Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months] | The EQ-5D health state scale is a visual analog scale that ranges from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating a better state of health. Participants were asked to rate their health state on a drawn line that started at 0 and ended at 100. A positive change from baseline in the health state score indicates that the participant's health state has improved. |
Countries
Germany, Italy, Norway, Russia, Spain, Sweden, United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| BOTOX® BOTOX® (botulinum toxin Type A) administered according to physician prescription for the treatment of chronic migraine; all treatment decisions lie with the physician. | 633 |
| Total | 633 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lack of Efficacy | 90 |
| Overall Study | Other Miscellaneous Reasons | 36 |
| Overall Study | Participant Concerned about Risks | 6 |
| Overall Study | Reason Missing | 1 |
| Overall Study | Side-effects or Health Problems | 15 |
| Overall Study | Thinks Injections Take Too Much Time | 2 |
| Overall Study | Thinks Injections Too Painful | 8 |
| Overall Study | Thinks it is Inconvenient | 17 |
| Overall Study | Trying to get Pregnant or Nursing | 2 |
Baseline characteristics
| Characteristic | BOTOX® |
|---|---|
| Age, Continuous | 45.4 years STANDARD_DEVIATION 11.7 |
| Sex: Female, Male Female | 540 Participants |
| Sex: Female, Male Male | 93 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 633 |
| other Total, other adverse events | 34 / 633 |
| serious Total, serious adverse events | 8 / 633 |
Outcome results
Mean Number of Days of Headache-related Hospital Admissions
The number of admission days is presented as the mean, normalized to a period of 90 days. The Baseline value included admissions during the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included admissions since the second-to-last visit.
Time frame: Baseline (previous 3 months prior to first dose of BOTOX@) to FU last [median 21.20 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, who were hospitalized.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| BOTOX® | Mean Number of Days of Headache-related Hospital Admissions | Baseline | 8.9 days | Standard Deviation 20.14 |
| BOTOX® | Mean Number of Days of Headache-related Hospital Admissions | FU last | 4.8 days | Standard Deviation 10.98 |
Percentage of Participants Admitted to the Hospital for Headache
The Baseline value included participants who had been admitted to the hospital for headache in the last 3 months prior to the baseline visit (first administration of BOTOX®); the Last Follow-up value included participants who been admitted to the hospital for headache since the previous visit.
Time frame: Baseline (previous 3 months prior to first dose of BOTOX®) and Last Follow-up Visit (FU last) [median 21.20 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| BOTOX® | Percentage of Participants Admitted to the Hospital for Headache | Baseline | 6.0 percentage of participants |
| BOTOX® | Percentage of Participants Admitted to the Hospital for Headache | FU last | 2.1 percentage of participants |
Percentage of Participants Who Visited Any Healthcare Professional (HCP)
The Baseline value included participants who had visited an HCP in the last 3 months prior to the baseline visit (first administration of Botox); the value for FU last included participants who visited an HCP since the second-to-last visit.
Time frame: Baseline (previous 3 months prior to first dose of BOTOX®) to FU last [median 21.20 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Any HCP Visit: Baseline | 45.8 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Any HCP Visit: FU last | 17.1 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Outpatient Consultation: Baseline | 33.3 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Outpatient Consultation: FU last | 6.8 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Accident and Emergency Visit: FU last | 2.6 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Alternative Practitioner: Baseline | 6.3 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Alternative Practitioner: FU last | 2.0 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Other: Baseline | 4.3 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Other: FU last | 0.5 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Primary Care Consultant Visit: Baseline | 30.6 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Primary Care Consultant Visit: FU last | 12.7 percentage of participants |
| BOTOX® | Percentage of Participants Who Visited Any Healthcare Professional (HCP) | Accident and Emergency Visit: Baseline | 6.3 percentage of participants |
Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score
The MSQ is a 14-item questionnaire to measure health-related quality-of-life attributed to migraine in the past 4 weeks. Each item is scored on a 6-point scale where: 1=none of the time to 6=all of the time. There are 3 dimensions: Role-function Restrictive (questions 1 to 7; score range 7 to 42), Role-function Preventive (questions 8 to 11; score range 4 to 24) and Emotional-function (questions 12 to 14; score range 3 to 18). The individual dimension scores were converted to a score of 0 to 100; the total score ranged from 0 to 300 with higher numbers representing a better quality of life. A positive change from baseline in the dimension scores and the total score indicates that quality of life has improved.
Time frame: Baseline to Last Administration of BOTOX® (ADM last) [median 20.30 months]
Population: Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available for analysis at the given time-point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Role Function-Restrictive: Baseline (BL) | 37.14 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Role Function-Preventive: Change BL to ADM last | 20.00 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Emotional Function: Change from BL to ADM last | 26.67 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Role Function-Restrictive: Change BL to ADM last | 25.71 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Role Function-Preventive: Baseline | 50.0 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Emotional Function: Baseline | 40.00 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Total Score: Baseline | 132.86 score on a scale |
| BOTOX® | Change From Baseline in Migraine-Specific Quality of Life Questionnaire (MSQ) Score | Total Score: Change from BL to ADM last | 70.95 score on a scale |
Change From Baseline in the EQ-5D Questionnaire Total Score
The EQ-5D consists of 5 dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) assessed by the participant using a 3-point scale: 1=no problems, 2=some problems and 3=extreme problems. The combination of levels from the 5 dimensions results in a health state code. The total score is calculated by converting the health state code into a score: start with score 1.000=\[11111\] (perfect health state), subtract 0.081 (constant) for any other state, subtract nothing for level 1 on any dimension, subtract appropriate level 2 or level 3 value for each dimension from a table of constants \[Level 2: Mobility 0.069, Self-care 0.104, Usual activity 0.036, Pain/discomfort 0.123, Anxiety/depression 0.071\] \[Level 3: Mobility 0.314, Self-care 0.214, Usual activity 0.094, Pain/discomfort 0.386, Anxiety/depression 0.236\], subtract 0.269 if any dimension has a level 3 problem. Higher numbers indicate better health. A positive change from Baseline indicates improvement.
Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]
Population: Participant from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| BOTOX® | Change From Baseline in the EQ-5D Questionnaire Total Score | Baseline | 0.69 score on a scale |
| BOTOX® | Change From Baseline in the EQ-5D Questionnaire Total Score | Change from Baseline to ADM last | 0.107 score on a scale |
Change From Baseline in the Health State Score of the EQ-5D Questionnaire
The EQ-5D health state scale is a visual analog scale that ranges from 0 (worst imaginable health state) to 100 (best imaginable health state), with higher scores indicating a better state of health. Participants were asked to rate their health state on a drawn line that started at 0 and ended at 100. A positive change from baseline in the health state score indicates that the participant's health state has improved.
Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| BOTOX® | Change From Baseline in the Health State Score of the EQ-5D Questionnaire | Change from Baseline to ADM last | 10.0 score on a scale |
| BOTOX® | Change From Baseline in the Health State Score of the EQ-5D Questionnaire | Baseline | 50.0 score on a scale |
Change From Baseline in the Number of Headache Days
At each visit, participants were asked to provide the number of headache days he/she experienced in the last month. A headache day was defined as 4 or more hours of continuous headache. A negative change from Baseline (less headache days) indicates improvement.
Time frame: Baseline (prior to first dose of BOTOX®) to ADM last [median 20.30 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available at the given time-point.
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| BOTOX® | Change From Baseline in the Number of Headache Days | Baseline | 20.0 days |
| BOTOX® | Change From Baseline in the Number of Headache Days | Change from Baseline to ADM last | -11.0 days |
Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction Scale
At each visit, participants and physicians were asked to indicate the level of satisfaction that he/she had with the treatment. Physicians indicated the level of satisfaction with the patient's treatment. The 4- point scale consisted of the following responses: insufficient, moderate, good and very good. The combined percentage of good and very good responses by participants and physicians are reported.
Time frame: ADM last [median 20.30 months]
Population: Participants from the Safety Analysis Set, all participants who received at least one dose of BOTOX®, with data available.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| BOTOX® | Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction Scale | Physician Assessment | 78.1 percentage of participants |
| BOTOX® | Percentage of Participants With Good or Very Good Responses on the 4-Point Treatment Satisfaction Scale | Patient Assessment | 76.0 percentage of participants |